摘要
目的探讨术前访视时行前瞻性干预对慢性鼻窦炎手术患者全身麻醉苏醒期躁动和术后恢复的影响。方法选择2019年12月至2020年10月在成都市大邑县人民医院行全身麻醉手术的80例慢性鼻窦炎患者,按随机数字表法分为D组和G组,各40例,D组按照常规方法行术前访视,G组按照前瞻性干预方法进行术前访视。记录两组患者术前30 min(T_(1))和术毕拔出气管导管后1(T_(2))、5(T_(3))、10(T_(4))、30 min(T_(5))时的血流动力学变化,比较两组患者干预前以及术后第一天焦虑、抑郁评分,并观察两组患者术后苏醒期躁动的发生率和并发症发生情况;采用鼻腔鼻窦结局测试量表-20(SNOT-20)评估两组术后恢复情况。结果G组苏醒期躁动发生率低于D组[7.5%(3/40)比25.0%(10/40],差异有统计学意义(χ^(2)=4.50,P<0.05)。两组T_(1)、T_(5)时收缩压、舒张压和心率比较差异无统计学意义(P>0.05),但T_(2)、T_(3)和T_(4)时G组上述指标水平均高于D组,差异有统计学意义(P<0.05)。术后第一天G组状态焦虑询问表(S-AI)和抑郁自评量表(SDS)评分低于D组[(35.45±5.32)分比(39.35±4.91)分、(35.42±7.82)分比(38.76±5.21)分],差异有统计学意义(P<0.05)。两组麻醉苏醒期并发症发生率比较差异无统计学意义(P>0.05)。两组患者术后鼻窦炎症状、鼻部症状、睡眠障碍、情感障碍评分较术前均降低,且G组低于D组,差异均有统计学意义(P<0.05)。结论麻醉前访视时行前瞻性干预应用于慢性鼻窦炎手术患者可减轻机体应激反应,改善不良情绪,降低苏醒期躁动发生率,促进术后恢复。
Objective To investigate the effect of prospective intervention on emergence agitation and postoperative recovery in patients with chronic sinusitis during preoperative visits.Methods A total of 80 patients with chronic sinusitis who underwent general anesthesia in Dayi County People′s Hospital of Chengdu City from December 2019 to October 2020 were selected and randomly divided into group D and group G,with 40 patients in each group.Group D received preoperative visit with conventional methods and group G received preoperative visit with prospective intervention methods.The hemodynamic changes of patients in the two groups at 30 min before the operation(T_(1))and 1(T_(2)),5(T_(3)),10(T_(4))and 30 min(T_(5))after tracheal tube extraction were recorded.The anxiety and depression scores of patients before the intervention and 1 d after the operation were compared between the two groups.The incidence of emergence agitation after the operation and complications during anesthesia awakening period were observed in the two groups,sino-nasal outcome test-20(SNOT-20)was used to assess the postoperative recovery.Results The incidence of emergence agitation in group G was lower than that in group D:7.5%(3/40)vs.25.0%(10/40),the difference was statistically significant(χ^(2)=4.50,P<0.05).There was no significant difference in systolic blood pressure,diastolic blood pressure and heart rate between the two groups at T_(1) and T_(5)(P>0.05),but the level of above indicators in group G at T_(2),T_(3) and T_(4) were significantly higher than those in group D(P<0.05).The scores of State-Trait Anxiety Inventory(S-AI)and Self-Rating Depression Scale(SDS)in group G at the first day after the operation were significantly lower than those in group D:(35.45±5.32)scores vs.(39.35±4.91)scores,(35.42±7.82)scores vs.(38.76±5.21)scores,the differences were statistically significant(P<0.05).The incidence of complications during anesthesia awakening period in group G was slightly lower than that in group D(P>0.05).After the operation,th
作者
刘建波
张伟
胡鹤
曹建刚
刘超
赵泽宇
杨海刚
程继明
Liu Jianbo;Zhang Wei;Hu He;Cao Jiangang;Liu Chao;Zhao Zeyu;Yang Haigang;Cheng Jiming(Department of Anesthesiology,Dayi County People′s Hospital of Chengdu City,Chengdu 611330,China;Department of Anesthesiology,Sichuan Rehabilitation Hospital Affiliated to Chengdu University of Traditional Chinese Medicine,Chengdu 611130,China;Department of Eye,Ear,Nose,Laryngeal and Neck Surgery,Dayi County People′s Hospital of Chengdu City,Chengdu 611330,China)
出处
《中国医师进修杂志》
2022年第8期717-720,共4页
Chinese Journal of Postgraduates of Medicine
基金
2020年成都市医学科研课题立项项目(2020129)。
关键词
鼻窦炎
外科手术
麻醉后护理
躁动
Sinusitis
Surgical procedures,operative
Postanesthesia nursing
Agitation
